What is a Normal PSA?
Each PSA assay technique lists an expected “normal” value. Usually it is about 4.0 ng/ml. There is at least one nomogram that suggests that this level is not always the same and can rise with age. There is more and more evidence that suggests that there is no safe or normal level and prostate cancer can exist in patients with values significantly less than 4.0. What is more important is the rate of increase (velocity) of PSA year after year or the rate at which velocity is increasing (acceleration). A rate of increase greater than 0.75 per year should trigger a biopsy. There are multiple other factors as well including prostate volume, presence of inflammatory disease (prostatitis), etc that can elevate the PSA.
